In Gastric Cancer Antibiotics Following Surgery Reduce Risk of Second Gastric Cancer
Among patients diagnosed with gastric (stomach) cancer, a combination of antibiotics against the bacterium Helicobacter pylori (H. pylori) significantly reduces the risk of developing a second gastric cancer. These results were recently published in the August 2008 issue of Lancet Oncology.
The prevalence of gastric cancer has been steadily declining in the United States but is still the leading cause of cancer in Asia, accounting for 18% of cancer deaths in Japan. Worldwide gastric cancer is the second leading cause of cancer deaths. Several factors have been associated with an increased risk of developing gastric cancer. These include:
- Infection with H. pylori bacteria
- High nitrate consumption
- Low dietary vitamin A and C
- Consumption of smoked foods
- Poor drinking water
- Lack of refrigeration
Many studies have indicated that eradication of the H. pylori infection may decrease the risk of developing gastric cancer, leading to the proposal that eradication of the infection could reduce the risk of a recurrence of gastric cancer. Patients with H. pylori are routinely treated with antibiotics in the United States and Europe. Chinese researchers have reported that eradication of H. pylori infection decreases the risk of gastric cancer in most persons but not in persons who have precancerous sites.
Researchers from Japan recently conducted a clinical trial to further evaluate the effects of treatment with antibiotics following surgery designed to eradicate H. pylori infections in patients with gastric cancer. The trial included 544 patients already diagnosed with early gastric cancer; they had had their cancer surgically removed. Patients were then treated with either antibiotics (amoxicillin and clarithromycin) for one week or no further therapy. With three years of follow up, the incidence of a second gastric cancer was reduced by 70% among patients treated with antibiotics.
These results appear to confirm the effectiveness of use of antibiotics to eradicate H. pylori in order to reduce gastric cancers. Patients diagnosed with gastric cancer may wish speak with their physician regarding their individual risks and benefits of treatment with antibiotics.
Reference: Fukase K, Kato M, Kikuchi S, et al. Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open label, randomized controlled trial. Lancet Oncology. 2008;372:392-397.